The 21st Century Cures Act and psychosocial electronic documentation in solid organ transplantation: Potential harms and practical strategies

Abstract

Recent health system initiatives and government legislation have enhanced electronic health information (EHI) sharing in the healthcare technology environment. These measures are favorably viewed by most patients and clinicians. The 21st Century Cures Act, whose final rules went into effect in the United States in 2021, prohibits information blocking practices except in the case of potential harm. The definition of such harm, particularly regarding psychosocial EHI, is unclear and little guidance has been published. No articles address the matter in solid organ transplantation (SOT) despite the crucial role of psychosocial data in organ allocation. This article describes the implications of patient and family access to psychosocial EHI in SOT, discusses potential mechanisms of harm, and suggests practical communication strategies relevant to clinicians of all disciplines to promote high quality care and favorable interactions with patients and families.

Keywords: donors and donation; editorial / personal viewpoint; informatics; internet; law / legislation; mental health; social sciences.

FIGURE 1

Plausible potential harm mechanism related to patient and family access to psychosocial electronic health information in living donation and solid organ transplantation.